Demographics and Inclusivity in CDI Survey

Question Title

* 2. Please indicate the race/ethnicity with which you identify (check all that apply):

African American/Black

East Asian

Hispanic/Latino

Middle Eastern

American Indian/Alaskan Native

Pacific Islander

South Asian

Caucasian/White

Other (please specify)

Question Title

* 3. Please indicate the gender with which you identify.

Cisgender woman

Cisgender man

Transgender woman

Transgender man

Non-binary

Prefer not to answer

Other (please specify)

Question Title

* 4. Please indicate the sexual orientation with which you identify.

Heterosexual

Gay/Lesbian

Bisexual

Pansexual

Asexual

Prefer not to answer

Other (please specify)

Question Title

* 5. In what region of the country do you work?

Northeast (CT, MA, ME, NH, NY, RI, VT)

North central (IA, IL, IN, MI, MN, NE, ND, OH, SD, WI)

West (AZ, CO, ID, MT, NM, NV, UT, WY)

Middle Atlantic (DE, MD, NJ, PA, DC)

Southeast (AL, FL, GA, KY, MS, NC, SC, TN, VA, WV)

South Central (AR, KS, LA, MO, OK, TX)

Pacific (AK, CA, HI, OR, WA)

Other (please specify if outside U.S.)

Question Title

* 6. What is your perception of ACDIS as an organization, with regard to racial diversity?

Diverse/no concerns

Neutral

Non-diverse/needs improvement

Not sure

Other (please specify)

Question Title

* 7. What is your perception of the CDI profession, with regard to racial diversity?

Diverse/no concerns

Neutral

Non-diverse/needs improvement

Not sure

Other (please specify)

Question Title

* 8. What is your perception of ACDIS as an organization and its values of racial diversity?

Welcoming/no concerns

Neutral

Needs improvement (please add your suggestion below)

Not sure

If you checked "needs improvement" please specify

Question Title

* 9. What is your perception of CDI as a profession and its values of racial diversity?

Welcoming/no concerns

Neutral

Needs improvement (please add your suggestion below)

Not sure

If you checked "needs improvement" please specify

Question Title

* 10. How diverse is the organization in which you work?

Very diverse

Somewhat diverse

Not diverse

Not sure

Other (please specify)

Question Title

* 11. How diverse is the CDI department in which you work?

Very diverse

Somewhat diverse

Not diverse

Not sure

Other (please specify)

Question Title

* 12. How active is the organization in which you work in promoting diversity and inclusion?

Very active

Somewhat active

Not active

Not sure

Other (please specify)

Question Title

* 13. Do you identify as being in a racial minority?

Yes

Not sure

Other (please specify)

Question Title

* 14. How well do you feel your race/ethnicity is represented by ACDIS as an organization?

Very well represented

Somewhat represented

Neutral

Not well represented

Other (please specify)

Question Title

* 15. How well do you feel your race/ethnicity is represented in CDI as a profession?

Very well represented

Somewhat represented

Neutral

Not well represented

Other (please specify)

Question Title

* 16. Have you experienced racial/ethnic bias in your CDI career?

Yes

Not sure

Please describe if yes

Question Title

* 17. Do you believe that racial/ethnic bias has hindered your CDI career?

Yes

Not sure

Please describe if yes

Question Title

* 18. Have you experienced racial/ethnic bias, at an ACDIS event or program?

Yes (please elaborate below)

Not sure

Please elaborate if yes

Question Title

* 19. Did you immigrate to the United States?

Yes

Prefer not to answer

Other (please specify)

Question Title

* 20. What steps would you recommend ACDIS take to ensure it is racially/ethnically diverse and welcoming?

Question Title

* 21. Are you willing to share your personal story as a person of color in an ACDIS publication (Journal article, ACDIS Podcast, or other)?

Yes

If yes, please provide any details.

Question Title

* 22. If you answered yes to the previous question, or if you would like, please provide your contact information (this is optional and you may remain anonymous if preferred, or place "N/A" in any fields you do not wish to include).

Name

Organization name

Title

Email Address

Phone Number

Demographics and Inclusivity in CDI

Question Title

* 1. Please indicate your title/role (check all that apply):

Question Title

* 2. Please indicate the race/ethnicity with which you identify (check all that apply):

Question Title

* 3. Please indicate the gender with which you identify.

Question Title

* 4. Please indicate the sexual orientation with which you identify.

Question Title

* 5. In what region of the country do you work?

Question Title

* 6. What is your perception of ACDIS as an organization, with regard to racial diversity?

Question Title

* 7. What is your perception of the CDI profession, with regard to racial diversity?

Question Title

* 8. What is your perception of ACDIS as an organization and its values of racial diversity?

Question Title

* 9. What is your perception of CDI as a profession and its values of racial diversity?

Question Title

* 10. How diverse is the organization in which you work?

Question Title

* 11. How diverse is the CDI department in which you work?

Question Title

* 12. How active is the organization in which you work in promoting diversity and inclusion?

Question Title

* 13. Do you identify as being in a racial minority?

Question Title

* 14. How well do you feel your race/ethnicity is represented by ACDIS as an organization?

Question Title

* 15. How well do you feel your race/ethnicity is represented in CDI as a profession?

Question Title

* 16. Have you experienced racial/ethnic bias in your CDI career?

Question Title

* 17. Do you believe that racial/ethnic bias has hindered your CDI career?

Question Title

* 18. Have you experienced racial/ethnic bias, at an ACDIS event or program?

Question Title

* 19. Did you immigrate to the United States?

Question Title

* 20. What steps would you recommend ACDIS take to ensure it is racially/ethnically diverse and welcoming?

Question Title

* 21. Are you willing to share your personal story as a person of color in an ACDIS publication (Journal article, ACDIS Podcast, or other)?

Question Title

* 22. If you answered yes to the previous question, or if you would like, please provide your contact information (this is optional and you may remain anonymous if preferred, or place "N/A" in any fields you do not wish to include).